During the routine exam of an infant the parents state a 5th degree family history of adenomatous polyposis. The statement that should be included during the discussion is the infant is at increased risk of colonic adenocarcinoma
- A. the infant is at increased risk of acute lymphocytic leukemia
- B. the infant is at increased risk of intestinal Burkitt lymphoma
- C. the infant is at increased risk of hepatoblastoma
- D. the infant is at increased risk of germ cell tumor
Correct Answer: C
Rationale: Familial adenomatous polyposis significantly increases the risk of developing colorectal cancer.
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An adult is on a clear liquid diet. Which food item can be offered/
- A. Milk
- B. Orange juice
- C. Jello
- D. Ice cream
Correct Answer: C
Rationale: When an adult is on a clear liquid diet, foods that are easy to digest and leave little residue in the gastrointestinal tract are recommended. Clear liquids include water, broth, fruit juices without pulp, and gelatin desserts like Jello. Jello is a good option because it is easily digestible, does not leave residue, and provides some calories and hydration. Milk, orange juice, and ice cream should be avoided on a clear liquid diet as they are not considered clear liquids and may not be as easily digestible.
A client is admitted to an acute care facility with a tentative diagnosis of hypoparathyroidism. The nurse should monitor the client closely for the related problem of:
- A. Severe hypotension
- B. Profound neuromuscular irritability
- C. Excessive thirst
- D. Acute gastritis
Correct Answer: B
Rationale: Hypoparathyroidism is a condition characterized by decreased levels of parathyroid hormone, which can lead to low levels of calcium in the blood (hypocalcemia). Profound neuromuscular irritability is a significant complication of hypocalcemia and is a key concern for clients with hypoparathyroidism. Symptoms can include muscle cramps, tetany, seizures, and decreased cardiac contractility. Monitoring for neuromuscular irritability and promptly addressing low calcium levels are essential in the care of clients with hypoparathyroidism.
Which intervention is appropriate for the nurse caring for a client in severe pain receiving a continuous I.V. infusion of morphine?
- A. Assisting with a naloxone challenge test before therapy begins
- B. Discontinuing the drug immediately if signs of dependence appear
- C. Changing the administration route to P.O. if the client can tolerate fluids
- D. Obtaining baseline vital signs before administering the first dose
Correct Answer: D
Rationale: Obtaining baseline vital signs before administering the first dose is appropriate for the nurse caring for a client in severe pain receiving a continuous I.V. infusion of morphine. Monitoring vital signs, including blood pressure, heart rate, respiratory rate, and oxygen saturation, is essential to assess the client's response to opioid therapy. Baseline vital signs provide a comparison for evaluating changes in the client's physical status and help identify any adverse effects or complications related to morphine administration. This proactive approach allows the nurse to detect and address any abnormalities promptly, ensuring the client's safety and optimal pain management.
A 5-year old boy presents with afebrile generalized tonic-clonic seizure lasting for 5 minutes. Previously he was healthy and had no such problem. On examination there is no abnormality. Your plan of management should be:
- A. Start anticonvulsant therapy
- B. Request for an EEG and wait for its report
- C. Request for an EEG and start anticonvulsant therapy immediately
- D. Request for EEG and MRI brain
Correct Answer: C
Rationale: In a first-time generalized seizure, an immediate EEG and starting anticonvulsant therapy is prudent to prevent recurrence, especially if the EEG shows epileptiform activity.
Regarding the physical growth of middle childhood (6-11 yr), all are true EXCEPT
- A. 3-3.5 kg weight increment/yr
- B. 6-7 cm height increment/yr
- C. brain myelinization stops by 8 yr
- D. deciduous tooth falls by 6 yr
Correct Answer: C
Rationale: Brain myelinization continues beyond 8 years.